Document 2652
 DOCN  M94A2652
 TI    Neonatal diagnosis of perinatal HIV-1 infection: the use of polymerase
       chain reaction in Brazilian infants.
 DT    9412
 AU    Mussi-Pinhata MM; Feres MC; Covas DT; Duarte G; Isaac ML; Clinical
       Hospital of Medical School of Ribeirao Preto-Un. of Sao; Paulo, Brazil.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):255 (abstract no. PB0449). Unique
       Identifier : AIDSLINE ICA10/94369923
 AB    OBJECTIVE: To evaluate the ability of the HIV-1
       polymerase-chain-reaction (PCR) testing to diagnose HIV-1 infection in
       neonates born to HIV-1 infected women in Ribeirao Preto. METHODS: Thirty
       seven infants born to HIV-1 infected women followed prospectively from
       birth had a neonatal blood sample (median age of 5.5 days, range 1 to 28
       days) tested by standard HIV-1 PCR (1 gag primer pair SK 38/39 and 1 env
       primer pair SK 68/69). The infants HIV-1 infection status was determined
       based on clinical signs and symptoms of disease (CDC criteria) and/or
       serology after 18 months of age. The neonatal PCR testing results were
       compared to the infection status of the infants. RESULTS: Of 30 children
       with complete follow up (median of 21 months), 9 (30%) had serological
       and clinical signs of HIV-1 infection and 21 (70%) were not infected.
       All the 9 infected infants were asymptomatic in the neonatal period.
       Among the infected infants. 5/9 (56%) had positive neonatal PCR tests
       and 4/9 (44%) had negative PCR tests. None of the 21 not infected
       children had positive PCR tests (specificity of 100%). The predictive
       value of a positive test was 100% and the predictive value of a negative
       test was 84%. Infected infants developed early (1 to 6 months of age)
       signs and symptoms of disease despite of their reactivity on neonatal
       PCR testing. The prognosis of PCR-positive and PCR-negative infants were
       similar. DISCUSSION AND CONCLUSIONS: The PCR testing done in the
       neonatal period detected half of the perinataly infected infants with
       good specificity. In spite of not detecting all infants, it is a useful
       tool for neonatal diagnosis and it might be identifying the newborns
       infected during gestation. This test should be repeated after the
       neonatal period to enhance its sensitivity. In addition, cheaper and
       less complex tests must be evaluated in developing countries for early
       diagnosis of perinatal HIV-1 infection.
 DE    Brazil  *Developing Countries  Female  Follow-Up Studies  Human  HIV
       Seropositivity/*DIAGNOSIS/TRANSMISSION  *HIV-1  Infant  Infant, Newborn
       Male  Neonatal Screening  Polymerase Chain Reaction/*METHODS  Pregnancy
       Prospective Studies  MEETING ABSTRACT

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